Sunday, December 28, 2014

Holiday Weekend Update

Well, we now are in the middle of the two week long end of the year holiday period. The FEHBlog enjoyed the Christmas holidays with his wonderful family.  Congress is keeping the home fires burning too.  Nevertheless, the Pharmacy Times reports that a bipartisan team on Congressmen will be introducing a bill to increase the transparency of generic drug pricing in the FEHBP, Medicare Part D, and TRICARE next month.  The burden of the law would fall principally on the prescription drug managers. Community pharmacists are leading the charge for its passage.

Federal News Radio reports on OPM's workforce goals for 2015.  OPM is requiring agencies to designate Senior Accountable Officials who will be responsible for improving employee engagement.

OPM earlier this month imposed now obligations on FEHBP carriers to root out fraud, waste, and abuse.  FEHBP carriers have every incentive to take such actions because they bear the financial risk of their health plans. In any event, the FEHBlog takes note of this fact because the Wall Street Journal wrote yesterday about how hard it is root fraud out of Medicare. The article explains that Medicare has problems screening bad actors out of the program and kicking bad actors out once they are identified. The article makes an interesting point:
[S]imple improvements to the screening process would make it easier to spot fake medical providers.  “Even to get a driver’s license, you need to take a driver’s education course and pass a test,” said Ryan Stumphauzer, former head of the Medicare Fraud Strike Force in Miami. “Why not perform this type of common-sense screening before handing out Medicare billing privileges? Ask basic questions: Does the applicant have education, training or experience in health care? Are they versed in basic Medicare rules and regulations?”
Hopefully Congress will impose this vetting obligation on the providers and their professional associations where the burden belongs.

Healthcare Data Management reports that 2014 was a landmark year for health care data breaches.
In the good old days before electronic records, there probably were a lot fewer breaches. Of the 10 most recent breaches according to Beckers Hospital Review, only one (#10) involved paper records. Putting this genie back in the bottle is impossible at this point (as illustrated by ONC's new five yer plan) but the government, which also has suffered data breaches, needs to be more understanding and take the lead in efforts to improve data security, in the FEHBlog's view.

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